• Title/Summary/Keyword: transluminal percutaneous

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Arterial Complication of Percutaneous Transluminal Angioplasty - A Report of Case - (경피 경관 혈관 성형술후 발생한 동맥내 합병증의 치험 1례)

  • 김상익
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1273-1277
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    • 1992
  • Percutaneous Transluminal Angioplasty[PTA] was introduced by Dotter and JudKins [1964], using coaxial catheters of increasing diameter. The remarkable advances in vascular catheter technology over the past several decades have permitted the development. But the application of the balloon catheters carries with it the risk of arterial injury, thrombosis, embolism, and loss of life or limb. A 53-year-old man was admitted to other hospital due to a intermittent claudication in his right leg for 10 years. and PTA was performed at that hospital. Thereafter he was transferred to our hospital because of coldness, pulselessness, rest pain, ischemic ulcer, and progressing gangrene at the anterior aspect of left lower leg. The left lower extremity was salvaged by left ilio-femoral bypass and later saphenous in situ femoro-popliteal bypass.

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Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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Difference in Healthcare Utilization for Percutaneous Transluminal Coronary Angioplasty Inpatients by Insurance Types: Propensity Score Matching Analysis (의료보장유형에 따른 Percutaneous Transluminal Coronary Angioplasty 입원 환자의 의료이용 차이 분석: Propensity Score Matching을 이용하여)

  • Seo, Eun-Won;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.25 no.1
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    • pp.3-10
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    • 2015
  • Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

The Usefulness of Infrapopliteal Percutaneous Transluminal Angioplasty in the Treatment of Diabetic Gangrene (당뇨병성 족부 괴저의 치료에서 무릎 밑 경피적 경혈관 혈관성형술의 유용성)

  • Choi, Jae-Yeol;Shin, Hun-Kyu;Kim, Eu-Gene;Kim, Jong-Min;Lee, Yong-Taek;Kim, Seung-Kwon;Kim, Jong-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.216-220
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    • 2007
  • Purpose: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene. Materials and Methods: Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation. Results: Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement. Conclusion: As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.

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A Case of Renovascular Hypertension Controlled by Percutaneous Transluminal Renal Angioplasty with Balloon Dilatation (경피적 신동맥 혈관 성형술로 치료한 신혈관 고혈압증 1례)

  • Park, Sung-Woo;Jeong, Su-Ho;Jeong, Young-Sun;Jun, Yong-Hoon;Hong, Young-Jin;Lee, Ji-Eun
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.105-110
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    • 2008
  • Renovascular hypertension results from a lesion that impairs blood flow to a part of or all, of one or both kidneys. Renal artery stenosis is the major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. Recently, percutaneous transluminal renal angioplasty(PTRA) with or without stent placement, has become the preferred choice for correcting symptomatic renal artery stenosis since it is less invasive than surgical reconstruction. PTRA with balloons designed for the dilatation for the dilatation of the coronary artery can be tried in small sized renal artery stenosis. We report a case of renovascular hypertension in a 13-year-old male who had small sized renal artery stenosis. Hypertension was controlled by PTRA with balloon dilatation.

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Emergency Surgery after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술후의 응급 관상동맥 우회술)

  • 박영환
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.73-78
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    • 1992
  • From Octorber 1984 through September 1991, 480 patients underwent percutaneous tra-nsluminal coronary angioplasty and 7 of these[1.4%] required coronary artery bypass surgeries in the emergency base. The principal indications for surgery were coronary dis-sections[n=2], acute coronary occlusions[n=3], and ventricular arrhythmias[n=2]. There were two early deaths and one late death. No patient who developed cardiac arrest and had not been resuscitated before surgery survived the operation. The outcome of surgery was related to the preoperative clinical status of patients.

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Transmyocardial Laser Revascularzation for Patients with Recurrent Angina after CABG -Report of 3 cases - (관상동맥 우회로술 후 재발한 협심증의 경심근 레이저 혈류 재건술 치험 3례)

  • Lee, Ho-Seok;Park, Kay-Hyun;Jun, Tae-Gook;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.576-580
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    • 2000
  • Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.

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Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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The Effects of Heat Therapy on Low Back Pain, Blood Pressure and Pulse Rate after Percutaneous Coronary Intervention (경피적 관상동맥 중재술 후 온요법이 요통, 혈압 및 맥박에 미치는 효과)

  • Yun, So-Young;Cho, Bok-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.348-355
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    • 2011
  • Purpose: This study was done to examine the effects of heat therapy on low back pain, blood pressure and pulse rate after percutaneous coronary intervention. Method: The participants in this study were 40 patients who were admitted after having percutaneous coronary intervention. The experimental group, 20 patients, had heat therapy and the control group, 20 patients, maintained a supine position for 12 hours after the intervention. Back pain (VAS), blood pressure and pulse rate were measured just after removal of the sheath, and at 2-hour intervals up to 6 hours. Data were analyzed using SPSS 15.0. Results: The experimental group had significantly lower VAS for low back pain (F=23.44, p=.001). However no significant differences were found between two groups for blood pressure and pulse rate. Conclusion: The findings indicate that heat therapy is effective in reducing low back pain in patients who have had percutaneous coronary intervention. Therefore, heat therapy could be used as nursing intervention percutaneous coronary intervention.

Usefulness of Percutaneous Transluminal Angioplasty before Operative Treatment in Diabetic Foot Gangrene (당뇨병성 족부 괴저에서 수술 전 시행한 경피적 경혈관 혈관성형술의 유용성)

  • Im, Chul Soon;Lee, Myoung Jin;Kang, Jung Mo;Cho, Young-Rak;Jo, Jeong Hyun;Lee, Chan Soo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.32-37
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    • 2018
  • Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.